Severely debilitating Chondromalacia Patella problems

[SuspectDevice]

I agree with every aspect of Suspectdevice's, or should I say Triagain's post. Just a few differences. I can tolerate biking well(perhaps because of fact that my chondromalacia is not caused by overbiking), and, secondly, tens machine doesn't help for pain in my knees.
Price of PRP shot should be around 120-150 Euros in Croatia.
Here I get my shots:
http://www.poliklinika-sunce.hr/lokacije/zadar/

Interestingly gcoza, my OS actually told me at their last conference they had a workshop on PFPS and reached the conclusion they were pretty clueless about its causes and treatment.  Amazing honesty for a bunch of orthopaedic surgeons I thought.

This, following years on the medical roundabout pretty much convinced me I needed to find my own solutions, but still read widely and listen to various medicos for new clues.  But I tend to get better clues from fellow knee-pain sufferers.

I also think a lot of medicos hope the placebo effect will win out the day if they sound confident enough that their treatments are recommended with enough authority.  And I'm sure this works in some cases for some people.  Unfortunately, my BS detector has become too highly developed in my older age.  There was a time I trusted medicos with everything.  Indeed my father was one.  But increasingly I recognise they are fallible, and in some cases just don't have the answer, so I have to figure it out mostly for myself.

[tinydinosaur]

Things of note you mentioned: VMO wasting, poor glute strength, knock knees.

Any sort of wasting or weak muscle can cause imbalance which can then exacerbate any underlying structural difficulties. Eg. a weak VMO can cause instability or tracking problems combined with knock knees could cause excess wear on a side of the joint.

Definitely give physio another go if your insurance covers it, try getting referred to another - more helpful - physio or a sports physio. They should be able to assess any muscle imbalance and help you correct it in the least aggravating way.

If there is a brace clinic near you see if you are allowed to test out some of their braces, specifically an offloading brace. If you are knock-kneed and/or your wear is on one side the braces pull your weight to one side, extending the life of your knee. Though I think that only helps for mild/moderate wear problems. There is also the option, with a good physio, of taping in a similar fashion. Tape is cheaper short term and also, if done properly, can mimic the affect of a brace (so you know without buying one if it's helpful to you).

The hyaluronic acid injections are different than cortisone, they are either a synthetic or a natural one. The idea behind it is to replace some joint fluid to help cushion/lubricate the joint, prolonging the period before surgery, like a knee replacement. Which is also what the idea behind the offloading brace is.

For me I assume the acid injections didn't work because the wear of cartilage was so bad AND I had severe muscle wasting exacerbating the issue.

[kchan808]

Have you hear of dr Lars blond I think he is a great orthopedic he operated on my left knee for a trochleoplasty on sept 27 2014. So far I am very pleased. I started running, jumping, and playing basketball. So far I am around 90-95% still have more strengthening to do. Here is a link where he talks about anterior pain email him if you have any questions. I highly recommend him.
Cheers

http://www.larsblond.com/knee.2.html#Anterior%20Knee%20Pain%20-%20Surgery

[Jasey122]

Whilst doing physio 3 weeks ago, we decided to start using a foam roller to stretch out my calf muscles in particular, quads and ITB. This has made a world of difference which as a result I am able to walk much better, stand longer and my pain levels have significantly decreased. Why it wasn't suggested earlier I dunno, but Im happy my recovery has started.

So thanks guys for all your support too. Ill keep updating

[SuspectDevice]

Whilst doing physio 3 weeks ago, we decided to start using a foam roller to stretch out my calf muscles in particular, quads and ITB. This has made a world of difference which as a result I am able to walk much better, stand longer and my pain levels have significantly decreased. Why it wasn't suggested earlier I dunno, but Im happy my recovery has started.

So thanks guys for all your support too. Ill keep updating

Intruiging and do keep posting to let us know if the foam rolling continues to give relief.

I have used the roller on quads & ITB from time to time and it helped a little, but you've convinced me to try it on my calves too.

[Jasey122]

Still an uphill struggle but it did make a difference using a foam roller and rolling device on my calves and the area under my knee joint. what ever it is called.

[Mikewithers86]

Thanks Vick. Like most surgeons , everyone is avoiding a replacement because of my age.

Having read through so many posts on this site, it seems there are more options outside the UK such as stem cell injections, PRP, Orthokine or even De Novo cartilage transplants. The problem is knowing which one to go for, because when I ask my docs they don't seem to be aware of these procedures.

I just got my mri report from the radiographer for my right knee which is the more painful of the knees. Can anyone please help or advise/ interpret the following please:

'There is an unstable chondral flap within the central third of the lateral retropatellar facet measuring 1.2cm in craniocaudal length and 1cm in width . Axial images 7-10 demonstrate full-thickness cartilage fissures the medial and lateral margins of the flap tear and high signal extending along the chondral bone interface between the two fissures. There is faint subcortical marrow oedema deep to the cartilage damage. There is heterogenous signal intensity within the medial retropatellar facet cartilage consistent with grade 1 chondromalacia.

Tibial tuberosity trochlear groove offset measures 10mm. No patella alta. Quadriceps insertion and patellar tendon are normal. There is moderate superolateral fat pad impingement'

Many thanks



How are you doing now???